Enhanced in vitro Platelet Aggregation in Hemodialysis Patients

Viener, A; Aviram, Michael; Better, Ori S.; Brook, J.G.

doi:10.1159/000183813

Cited by 71 publications

(42 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…25,29 In addition, HD patients are known to have abnormalities in platelet function, such as hyperaggregability and decreased responsiveness to prostacyclin. 30 Moreover, HD is likely to activate plasma coagulation factors, 31 which eventually leads to mural thrombus formation, resulting in restenosis in the early stage after PCI.…”

Section: Discussionmentioning

confidence: 99%

Sirolimus-Eluting Stents vs Bare Metal Stents for Coronary Intervention in Japanese Patients With Renal Failure on Hemodialysis

Aoyama

Ishii

Toriyama

et al. 2008

Circ J

View full text Add to dashboard Cite

atients with end-stage renal disease (ESRD) on hemodialysis (HD) are at high risk of death from ischemic heart disease. 1-3 Furthermore, percutaneous coronary intervention (PCI) in such patients is sometimes difficult because they have more complex lesions, including massive calcification of coronary lesions and/or multivessel disease than non-HD patients. 4 Published reports have indicated that using new devices such as stents or debulking devices is associated with better outcomes after PCI in HD patients. 5,6 However, the restenosis rate in the follow-up period is higher in HD patients than in non-HD patients, although the initial success rate of PCI is similarly high in both groups. 7-10 Therefore, higher rates of restenosis remain a clinical limitation of cardiac interventions in HD patients.Recently it was reported that sirolimus-eluting stents (SES) significantly reduce the risk of restenosis after PCI in many cases, [11][12][13][14][15] and the remarkable safety and efficacy of SES has been documented not only by angiography but by intravascular ultrasound (IVUS) as well. 16,17 Moreover, even in patients with high-risk factors for coronary restenosis, including diabetes, small diameter vessels, chronic total occlusion and so on, clinical improvement has been observed. [18][19][20][21] Accordingly, in the present study we aimed to determine the efficacy of SES in patients on maintenance HD. Methods Study PopulationFrom August 2004, SES have been available in our institution, so between August 2004 and July 2005 we attempted to implant SES for all patients who needed PCI if they had no contraindications, such as acute coronary syndrome, intolerance of both of aspirin and ticlopidine, planned surgery and so on. In total, 225 consecutive Japanese patients with 322 lesions treated with SES (Cypher™) for native coronary lesions during that period were designated as the SES group and 256 patients with 307 lesions treated with bare metal stents (BMS) in the preceding 1 year were the BMS group. Of these, 166 patients with 216 lesions (88 patients with 121 lesions in the SES group and 78 patients with 95 lesions in the BMS group) received maintenance HD 3 times a week. In advance, we excluded patients who were diagnosed with acute myocardial infarction (MI), underwent bypass grafting, had a contraindication for the use of aspirin and/or ticlopidine, or were >85 years of age.Lesions were suitable for PCI if they were de novo

show abstract

Section: Discussionmentioning

confidence: 99%

Sirolimus-Eluting Stents vs Bare Metal Stents for Coronary Intervention in Japanese Patients With Renal Failure on Hemodialysis

Aoyama

Ishii

Toriyama

et al. 2008

Circ J

View full text Add to dashboard Cite

show abstract

“…It has been reported that HD patients have abnormalities in platelet function (28). Furthermore, HD itself may activate plasma coagulation factors (29).…”

Section: Discussionmentioning

confidence: 99%

Cilostazol Improves Long-Term Patency after Percutaneous Transluminal Angioplasty in Hemodialysis Patients with Peripheral Artery Disease

Ishii

Kumada

Toriyama

et al. 2008

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Several factors, including hypertension, increased propensity to thrombus formation, alteration in the fibrinolytic system and HD itself, may thus tend to induce aggressive atherosclerosis, eventually leading to diffuse multivessel disease and to rapid restenosis after PTCA [10]. In particular, the perturbations of platelet responsiveness and coagulation cascades may promote aggressive restenosis in HD patients [9,21,22]. Furthermore, such patients also have additional risk factors, such as an abnormal calcium-phosphorus Am J Nephrol 1999;19:38- 44 Sanai/Kimura/Inenaga/Nonogi/Haze/Omae metabolism, hyperlipidemia and an abnormal carbohydrate metabolism, which may also aggravate atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Percutaneous Transluminal Coronary Angioplasty for Patients on Hemodialysis

et al. 1999

View full text Add to dashboard Cite

Ischemic heart disease has become more important in regard to mortality in hemodialysis (HD) patients. We examined the therapeutic outcome of initial percutaneous transluminal angioplasty (PTCA) in maintenance HD patients with angina pectoris. They consisted of 8 men and 4 women with a mean age of 56.3 ± 8.6 years and a mean duration of HD of 4.3 ± 4.0 years. Thirty-six non-HD patients treated with initial PTCA were matched for age, sex and coronary risk factors, and used as a control. Angiographic lesion success was confirmed by angiography in 21 (84%) of the 25 stenotic sites attempted and clinical success was obtained in 9 (75%) of the 12 HD patients, while there were 40 (78%) lesions successfully removed out of the 51 stenotic sites and there were 26 (72%) clinically successful cases out of the 36 non-HD patients, respectively. Angina recurred in 4 (44%) of 9 HD patients, and in 10 (38%) of 26 non-HD patients after successful PTCA, where the follow-up periods were 23 ± 20 and 28 ± 25 months, respectively. There was no significant difference in cumulative lesion survival curve between the two groups. In conclusion, PTCA for chronic HD patients is as effective as that for non-HD patients, at least regarding initial PTCA.

show abstract

Enhanced in vitro Platelet Aggregation in Hemodialysis Patients

Cited by 71 publications

References 21 publications

Sirolimus-Eluting Stents vs Bare Metal Stents for Coronary Intervention in Japanese Patients With Renal Failure on Hemodialysis

Sirolimus-Eluting Stents vs Bare Metal Stents for Coronary Intervention in Japanese Patients With Renal Failure on Hemodialysis

Cilostazol Improves Long-Term Patency after Percutaneous Transluminal Angioplasty in Hemodialysis Patients with Peripheral Artery Disease

Efficacy of Percutaneous Transluminal Coronary Angioplasty for Patients on Hemodialysis

Contact Info

Product

Resources

About